Low Morning Cortisol Levels Linked to Psychosis

A new study shows that patients with psychosis, even those with a recent onset, fail to produce adequate levels of cortisol when they first wake up in the morning. The meta-analysis conducted by researchers is the first to compare cortisol levels in schizophrenia patients with their current stage of illness.

The new findings may help doctors successfully identify people who will develop full-blown psychosis among those who seek help in the early stages of the disease.

“Only some 20 to 30 percent of individuals who are at high-risk of developing psychosis due to their clinical presentation or family history actually do so. Identifying those people early is where the cortisol measurement comes in,” said associate professor Zoltan Sarnyai, of James Cook University (JCU) in Australia.

“Biomarkers are very few and far between in psychiatry, so even though a huge amount of work is still needed, this could become a valuable technique.”

For the research, scientists conducted a meta-analysis of 11 studies. A meta-analysis is a method that scientists use to combine data from multiple research studies to examine a single hypothesis. It is considered a powerful tool in scientific analysis of data pooled from multiple investigations.

Their findings reveal that patients with schizophrenia tend to have very low levels of the stress hormone cortisol just after waking up compared to healthy people.

The levels of cortisol in a person’s body upon waking is called the cortisol awakening response (CAR). Normally there is a sharp increase in cortisol levels within a few minutes of waking up in the morning. In patients with schizophrenia, however, these levels are consistently lower.

Scientists had suspected cortisol played a role in psychotic disorders for a long time, but until now, some results had been contradictory, said co-author of the study, JCU’s Dr. Maximus Berger.

“We were able to show that patients with psychosis fail to produce cortisol after they wake up in the morning. We found this even in patients with recent onset of the illness,” said Berger.

The findings provided some evidence to suggest that high-risk individuals who later develop psychosis are already experiencing changes in cortisol even before they develop the illness.

Sarnyai added that low CAR levels are also an indicator of risk for other chronic diseases and have been linked to systemic inflammation and changes in the gut flora. This means that there is potential for early diagnosis and treatment of these conditions as well.

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About Traci Pedersen

Traci Pedersen is a professional writer with over a decade of experience. Her work consists of writing for both print and online publishers in a variety of genres including science chapter books, college and career articles, and elementary school curriculum.